Provider Demographics
NPI:1285900530
Name:CHEEK, CHRISTOPHER CORY (IDC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CORY
Last Name:CHEEK
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 357110
Mailing Address - Street 2:NAVAL AIR STATION NORTH ISLAND BLDG. 290
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8855 BUSHY HILL DR UNIT B
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-6348
Practice Address - Country:US
Practice Address - Phone:702-277-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman